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  • Title: Inhibition of enamel mineral loss by fissure sealant: an in situ study.
    Author: Kantovitz KR, Pascon FM, Nociti FH, Tabchoury CP, Puppin-Rontani RM.
    Journal: J Dent; 2013 Jan; 41(1):42-50. PubMed ID: 23044387.
    Abstract:
    OBJECTIVES: This study evaluated the effect of fluoride and non-fluoride sealants on hardness decrease (HD) and marginal adaptation (MA) on enamel substrates after cariogenic challenge. METHODS: Occlusal enamel blocks, from human third molars, were randomly divided into six groups (n=12), according to occlusal fissures condition (S - sound; C - caries-like lesion; CF - caries-like lesion+topical fluoride) and sealants (F - FluroShield; H - Helioseal Clear Chroma). Lesion depths were 79.3±33.9 and 61.3±23.9 for C and CF groups, respectively. Sealants were placed on occlusal surface and stored at 100% humidity (37°C; 24h/d). HD was measured by cross-sectional microhardness analysis at the sealant margin distances: -1 (under sealant), 0 (sealant margin), 1, 2 (outer sealant). Sealant MA was observed by polarized light microscopy and scored according to: 0 - failure (no sealant MA or total sealant loss); 1 - success (sealant MA present). MA and HD were analysed by ANOVA-R and mixed model analysis, respectively. RESULTS: For HD (ΔS), F values (6900.5±3686.6) were significantly lower than H values (8534.6±5375.3) regardless of enamel substrates and sealant margin distances. Significant differences were observed among sealant margin distances: -1 (5934.0±3282.6)<0 (8701.5±6175.7)=1 (8473.2±4299.4)=2 (7761.5±4035.1), regardless of sealant and substrate. MA was similar for all groups (p≥0.05). CONCLUSION: MA was not affected by sealant type or substrate condition, whereas enamel HD was favourably impacted by fluoride in the sealant. In addition, sealants were more effective as a physical barrier than as its chemical potency in reducing enamel HD. CLINICAL SIGNIFICANCE: Sealing with a fluoride material is a recommended procedure to prevent caries of occlusal permanent molars in high-caries-risk patients, even though those exhibiting white spot lesions, since the enamel hardness decrease when fluoride sealant was used in vitro.
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